Date: 28-Jan-2024

Initial Premium Paid Certificate

Duration For Which the Premium is Received: 28-Jan-2024 to 28-Feb-2024
Personal Details

Policy Number 155039845 Policyholder Name Mr Rinku Ahmad

Mobile No. 8981165261 Landline no. 9155974725
Email ID rinkukjan@gmail.com Current residential state: BIHAR
Commuinication Address: WARD NO 6 A SASARAM
Life Insured Name Mr Rinku Ahmad
MOHALLA- DARGAH
DARWAZA, DHARAMSHALA PAN Number DPNPR7041B
SASARAM 821115
Policy Details

Plan Name: Max Life Smart Wealth Advantage Guarantee Plan - 104N124V06
Policy Term 30 Years Premium Payment Frequency Monthly
Date of Commencement 28-Jan-2024 Date of Maturity 28-Jan-2054
Last Premium Due Date 28-Jan-2024 Next Due Date 28-Feb-2024
Reinstatement Interest
Rs. 0.00 Model Premium (incl. GST) Rs. 986
(incl.GST/S.Tax)
Total Premium Received Total Sum Assured of base
Rs.986 Rs. 121165
(incl.GST/S.Tax)* plan and term rider (if any)
Agent's Name Internet Sales Agent's Contact No.
GST Details

Coverage Type SAC Code GST/S.Tax(INR) GSTIN 06AACCM3201E1Z7

Base 997132 Rs.986 GST Regd. State Haryana
Rider 997132 Rs. 0.00
Reinstatement
Rs. 0.00
Interest
Total Rs. 986

Important Note:
*For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk commencement starts
after acceptance of risk by us. *Amount received would be adjusted against the due premium as per terms and conditions of the policy. *Premium paid would be eligible for deduction as per the provision
of Income Tax Act, 1961. Kindly consult your tax advisor for more information. Tax benefits are liable to change due to changes in legislation or government notification. *Applicable Taxes, Cesses and
Levies, as per prevailing laws, shall be borne by you. *For GST purposes,this premium receipt is Tax Invoice.Assessable Value in GST for Endowment First Year is 25%, Renewal Year is 12.5%; Single
Premium Annuity is 10%; Term and Health is 100%. In case of unit linked product GST is applicable on charges.
#
This is a confirmation that payment has been received by Policybazaar and transferred to the Insurer. The Insurer will release a final receipt along with the policy document.

Image: Sign

Authorised signatory

PRM23 V2.6 24112017

Image: footerSection.jpg